title: Reduced metabolism in brain "control networks" following cocaine-cues exposure in female cocaine abusers.
abstract: OBJECTIVE
  Gender differences in vulnerability for cocaine addiction have been reported. Though the mechanisms are not understood, here we hypothesize that gender differences in reactivity to conditioned-cues, which contributes to relapse, are involved.
  
  
  METHODS
  To test this we compared brain metabolism (using PET and ¹⁸FDG) between female (n = 10) and male (n = 16) active cocaine abusers when they watched a neutral video (nature scenes) versus a cocaine-cues video.
  
  
  RESULTS
  Self-reports of craving increased with the cocaine-cue video but responses did not differ between genders. In contrast, changes in whole brain metabolism with cocaine-cues differed by gender (p<0.05); females significantly decreased metabolism (-8.6%±10) whereas males tended to increase it (+5.5%±18). SPM analysis (Cocaine-cues vs Neutral) in females revealed decreases in frontal, cingulate and parietal cortices, thalamus and midbrain (p<0.001) whereas males showed increases in right inferior frontal gyrus (BA 44/45) (only at p<0.005). The gender-cue interaction showed greater decrements with Cocaine-cues in females than males (p<0.001) in frontal (BA 8, 9, 10), anterior cingulate (BA 24, 32), posterior cingulate (BA 23, 31), inferior parietal (BA 40) and thalamus (dorsomedial nucleus).
  
  
  CONCLUSIONS
  Females showed greater brain reactivity to cocaine-cues than males but no differences in craving, suggesting that there may be gender differences in response to cues that are not linked with craving but could affect subsequent drug use. Specifically deactivation of brain regions from "control networks" (prefrontal, cingulate, inferior parietal, thalamus) in females could increase their vulnerability to relapse since it would interfere with executive function (cognitive inhibition). This highlights the importance of gender tailored interventions for cocaine addiction.
authors.affiliation: National Institute on Drug Abuse, Bethesda, Maryland, United States of America. nvolkow@nida.nih.gov
authors.forename: Nora D
authors.initials: ND
authors.lastname: Volkow
authors.forename: Dardo
authors.initials: D
authors.lastname: Tomasi
authors.forename: Gene-Jack
authors.initials: GJ
authors.lastname: Wang
authors.forename: Joanna S
authors.initials: JS
authors.lastname: Fowler
authors.forename: Frank
authors.initials: F
authors.lastname: Telang
authors.forename: Rita Z
authors.initials: RZ
authors.lastname: Goldstein
authors.forename: Nelly
authors.initials: N
authors.lastname: Alia-Klein
authors.forename: Christopher
authors.initials: C
authors.lastname: Wong
mesh_terms: D001921:Brain / Q000378:metabolism* / Q000502:physiology; D001931:Brain Mapping / Q000379:methods; D003042:Cocaine; D019970:Cocaine-Related Disorders / Q000378:metabolism* / Q000523:psychology*; D003213:Conditioning, Psychological / Q000502:physiology; D003463:Cues; D015536:Down-Regulation; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D008297:Male; D008954:Models, Biological; D009415:Nerve Net / Q000378:metabolism*; D010775:Photic Stimulation; D049268:Positron-Emission Tomography; D012727:Sex Characteristics; D012931:Social Environment
chemical_list: D019788:Fluorodeoxyglucose F18; D003042:Cocaine